Advances in Shock Management and Fluid Resuscitation in Children

Shock in children is associated with signifcant mortality and morbidity, particularly in resource-limited settings. The principles of management include early recognition, fuid resuscitation, appropriate inotropes, antibiotic therapy in sepsis, supportive therapy for organ dysfunction, and regular hemodynamic monitoring. During the past decade, each step has undergone several changes and evolved as evidence that has been translated into recommendations and practice. There is a paradigm shift from protocolized-based care to personalized management, from liberal strategies to restrictive strategies in terms of fuids, blood transfusion, ventilation, and antibiotics, and from clinical monitoring to multimodal monitoring using bedside technologies. However, uncertainties are still prevailing in terms of the volume of fuids, use of steroids, and use of extracorporeal and newer therapies while managing shock. These changes have been summarized along with evidence in this article with the aim of adopting an evidence-based approach while managing children with shock.

Analysis of Sexually Transmitted Infections Prevention Campaigns between 2008 and 2020 / Análise de Campanhas Preventivas a Infecções Sexualmente Transmissíveis entre 2008 e 2020

Abstract This study aimed to analyze the sexually transmitted infections (STIs) prevention campaigns promoted by the Brazilian Ministry of Health between 2008 and 2020. Fifty-three campaigns from the digital archive were included in the directed content analysis. The analysis was conducted based on the concepts of Combination Prevention and the Theory of Planned Behavior (TPB). Condom use and STI testing were constantly promoted, to the detriment of alternative preventive behaviors. The TPB concepts in the campaigns suggest the compatibility of the materials with the theory. We conclude that the campaigns present the desirable aspects of prevention. However, recent campaigns focused on aversive materials, which goes against studies that report negative effects from these strategies and is associated with the rise of moralist perspectives on prevention.

Resumo Objetivou-se analisar as campanhas de prevenção a infecções sexualmente transmissíveis (ISTs) veiculadas pelo Ministério da Saúde entre 2008 e 2020. Cinquenta e três campanhas disponíveis no acervo digital foram incluídas na análise de conteúdo dirigida. A análise foi realizada com base nos conceitos da Prevenção Combinada e da Teoria do Comportamento Planejado (TCP). O uso de camisinha e a realização de testagem para ISTs foram constantemente promovidos, em detrimento de comportamentos preventivos alternativos. Os conceitos da TCP nas campanhas indicam compatibilidade dos materiais com pressupostos teóricos. Conclui-se que as campanhas abordam os aspectos desejáveis da prevenção. Contudo, as campanhas mais recentes investiram em materiais aversivos, estratégia contraindicada por outros estudos, porém associada ao crescimento da perspectiva moralista de prevenção.

Impact of communication campaigns to Blaan indigenous peoples covered by Community Health and Development Program, University of the Philippines Manila

Background@#The Community Health and Development Program (CHDP) is a longstanding program of the University of the Philippines (UP) Manila, School of Health Sciences, Extension Campus in South Cotabato. While its service goes beyond teaching and extends to community development projects benefiting indigenous sectors, yet there has been no comprehensive and systematic evaluation on the program's health communication materials which promote culturally safe and acceptable health care practices that lead to normative changes.@*Objective@#Using descriptive-interpretive qualitative approach, the researcher identified the communication approaches and documented their health knowledge, attitude, and practices (KAP) to identify any normative changes.@*Methodology@#A total of 24 respondents gave their views on the program's dengue, malnutrition, teenage pregnancy, and family planning campaigns using a closed-ended survey, qualitative KAP analysis, and ethnovideography.@*Results@#Results showed that information dissemination is limited to printed media and interpersonal communication via small groups; contents of health communication campaigns are less understandable; and social mobilization efforts demonstrated low levels of community engagement. Also, communication between health workers and Blaan indigenous peoples is not transactional due to the lack of feedback and involvement in the decision-making process. The respondents' knowledge on health demonstrated low levels of end-user engagement reflective of unsustainable knowledge on modern medicine. Normative changes are only evident on family planning campaigns.@*Conclusion@#The long-term sustainability of health promotion among indigenous peoples may be inhibited due to non-evident normative changes that trigger societal transformation. The paper suggests that a specialized communication strategy intended for Blaan indigenous peoples must be considered and applied in order to react collectively and effectively to address health issues.

Analysis of prevention and control results of three-year campaign for Kashin-Beck disease in Pingliang City, Gansu Province / 中华地方病学杂志

Objective:To learn about the current situation of prevention and control results of three-year campaign for Kashin-Beck disease (KBD) in Pingliang City, and to provide scientific basis for prevention and control of KBD.Methods:A retrospective analysis was carried out to collect the KBD surveillance data of all villages in the counties (cities, districts) affected by KBD in Pingliang City, Gansu Province during 2019 - 2020 from the "National Integrated Management System for Endemic Disease Prevention and Control (Three-year Campaign Action Management System)", including, the prevalence of children aged 7 to 12 years old, the implementation of prevention and control measures, and the case investigation, the establishment, management of health files and treatment of current patients.Results:Patients with KBD were distributed in 6 counties (cities, districts), 64 townships (towns), and 690 villages in Pingliang City, and all of them were seriously ill area. In 2019 and 2020, 40 537 and 41 053 children aged 7 to 12 years old were examined, respectively, and the clinical detection rate was 0.08% (31/40 537) and 0.03% (12/41 053), respectively; the X-ray detection rate was 0 in each year. In the dietary structure of residents in Pingliang City from 2018 to 2020, the consumption proportions of rice, flour and other diets was 15.03%, 76.63% and 8.34%, respectively, and the purchase proportion of staple food was 19.28%. From 2018 - 2020, 9 564 households and 36 282 people had been relocated from the affected areas, 4 831 children aged 7 to 12 years old had been raised in different places, 14.81% (420 914/2 842 939) of the original cultivated land had been converted to cash crops, 21.81%(620 045/2 842 939) of the original cultivated land had been converted from farmland to forest (grass), and 231 811 nutrition package for children aged 6 to 24 months had been given. A total of 6 269 KBD patients were investigated and registered, including 3 722 males and 2 547 females, with a gender ratio of 1.00 ∶ 0.68. The most clinical grading was grade Ⅰ, accounting for 78.00% (4 890/6 269), followed by grade Ⅱ (15.89%, 996/6 269) and grade Ⅲ (6.11%, 383/6 269); the age of onset was (64.57 ± 10.01) years old, ranging from 16 to 87 years old; most patients were over 50 years old, accounting for 86.57% (5 427/6 269). In 2019, 1 659 KBD patients were treated. The apparent efficiency, effective efficiency and ineffective efficiency were 25.38% (421 cases), 52.92% (878 cases) and 21.70% (360 cases), respectively. In 2020, 1 395 KBD patients were treated; the apparent efficiency, effective efficiency and ineffective efficiency were 19.50% (272 cases), 61.65% (860 cases) and 18.85% (263 cases), respectively.Conclusions:All villages in KBD area in Pingliang City have reached the elimination standard and achieved the elimination goal. We should continue to do a good job in the dynamic monitoring of the disease, strengthen the implementation of prevention and control measures and rehabilitation intervention for patients with KBD, and improve the quality of life of patients.

Efetividade de uma campanha para redução de desperdício em uma unidade de alimentação e nutrição / Effectiveness of a waste reduction campaign in a supply and nutrition unit

Resumo Introdução A Food and Agriculture Organization of the United Nations estima que um terço do alimento produzido no mundo é desperdiçado ou se perde ao longo das cadeias produtivas de alimentos, sendo que 46% das perdas ocorrem no processo das vendas e hábitos dos consumidores. Objetivo Este trabalho teve por objetivo quantificar e analisar a eficácia de uma campanha de intervenção por conscientização para o combate ao desperdício de alimentos em uma unidade de alimentação e nutrição. Método Foi estabelecido o índice per capita de resto-ingestão. A coleta desse dado foi realizada durante 25 dias, sendo 10 dias antes, 5 dias durante e 10 dias depois da campanha de conscientização. Resultados Houve redução da média per capita do resto-ingestão de 60,0 ± 14,9 para 39,3 ± 13,4; esse dado concordou com trabalhos existentes na literatura sobre o assunto. Pôde-se também contabilizar uma diminuição do custo financeiro médio em torno de 34,6%. Conclusão Constata-se com este estudo que a falta de conscientização dos comensais contribui significativamente para o alto desperdício de alimentos, pois foi notória a redução do desperdício por resto-ingestão após intervenção.

Abstract Background The Food and Agriculture Organization of the United Nations estimates that one-third of the food produced in the world is wasted or lost along the food supply chains; with 46% of the losses in the sales process and by consumer habits. Objective This study aimed to quantify and analyze the effectiveness of an intervention for awareness to combat food waste in a supply and nutrition unit. Method Per capita index of rest-ingestion was applied. The collection of this data was done for 25 days, being 10 days before, 5 days during and 10 days after the awareness campaign. Results There was a reduction of the per capita mean rest-ingestion from 60.0 ± 14.9 to 39.3 ± 13.4; this data agreed with works in the literature on the subject. It was also possible to account for a decrease in the average financial cost of around 34.6%. Conclusion It was found in this study that the lack of awareness of diners contributes significantly to the high food waste, because it was notorious the reduction of the indicator of rest-ingestion waste after intervention.

Clinico-Epidemiological Profile of New Leprosy Cases Detected in Leprosy Case Detection Campaign in North Maharashtra during 2018–2020

Leprosy is a leading cause of disability in India. The percentage of disability and deformity can be reduced by diagnosing leprosy at an early stage. In order to detect the hidden leprosy cases, leprosy case detection campaigns, on line with Pulse Polio Campaign have been introduced specifically for high endemic districts, by the Central Leprosy Division. Records of cases from 2018 to 2020 were evaluated retrospectively to study the trend of new cases. The present study denotes the presence of hidden undiagnosed cases in the community and will require an intensification of leprosy control activities through contact tracing and active case detection. Continued quality surveillance is required for early detection, timely management, and prevention of the spread of the disease.

A campanha de vacinação contra o SARS-CoV-2 no Brasil e a invisibilidade das evidências científicas / The SARS-CoV-2 vaccination campaign in Brazil and the invisibility of science evidences

Resumo O presente texto trata de refletir sobre a campanha de vacinação contra COVID-19 no Brasil à luz da consideração das evidências científicas no processo de tomada de decisão. O Brasil possui um dos maiores e mais completos programas de vacinação do mundo, o Programa Nacional de Imunizações (PNI). Infelizmente, no contexto atual, com as interferências políticas do governo federal, o PNI perdeu seu protagonismo na condução da campanha de vacinação contra a COVID-19. Apesar de ser uma campanha de vacinação com muito potencial e uma das mais aceitas pela população entre os países no mundo, apresentou muitos problemas e deixou diversas lacunas no cenário brasileiro. Nesse sentido, é fundamental que as evidências científicas de qualidade produzidas nesse período possam guiar uma remodelagem constante da estratégia de vacinação. Quatro pontos merecem ser destacados: 1) o intervalo entre as doses; 2) a intercambialidade entre vacinas; 3) a vacinação em adolescentes; e 4) a necessidade de melhores evidências para definir a estratégia de vacinação em certos grupos e faixas etárias.

Abstract This paper reflects on the vaccination campaign against COVID-19 in Brazil in light of the consideration of scientific evidence in the decision-making process. Brazil has one of the largest and most complete vaccination programs in the world, the National Immunization Program (Programa Nacional de Imunizações or PNI). Unfortunately, in the current context, with the political interference of the federal government, the PNI lost its role in conducting the vaccination campaign against COVID-19. Despite being a vaccination campaign with a lot of potential and one of the most accepted by the population among countries in the world, it presented many problems and left several gaps in the Brazilian scenario. In this sense, it is essential that the quality scientific evidence produced during this period can guide a constant remodeling of the vaccination strategy. Four points deserve to be highlighted: 1) the interval between doses; 2) the interchangeability between vaccines; 3) vaccination in children and adolescentes; and 4) the need for better evidence to define the vaccination strategy in certain groups and age groups.

Impactos da pandemia de COVID-19 sobre o tratamento para cessação do tabagismo / Impacts of the COVID-19 pandemic on smoking cessation treatment

Introdução: A pandemia do novo coronavírus teve repercussões no funcionamento dos sistemas de saúde do mundo inteiro. O tabagista foi um grupo diretamente afetado por essas mudanças. Objetivo: Mensurar esse impacto a partir da análise dos dados do Programa Estadual de Controle ao Tabagismo de Pernambuco. Método: Estudo descritivo transversal, utilizando como unidades de análise dados da estratégia de monitoramento do Programa Estadual de Controle ao Tabagismo da Secretaria Estadual de Saúde de Pernambuco (SES-PE), comparando os atendimentos no segundo quadrimestre dos anos de 2019 e 2020. Resultados: Entre maio e agosto de 2019, 3.282 pacientes tabagistas buscaram tratamento para cessação do tabagismo no SUS, em Pernambuco. Em período similar, entre os meses de maio e agosto do ano de 2020, o tratamento para cessação do tabagismo foi procurado por 680 usuários tabagistas, representando uma queda de 79,28%. Além disso, o número de municípios oferecendo tratamento para cessação do tabagismo no SUS caiu de 97 para 36 (62,89%) e o número de unidades de saúde da atenção básica realizando tratamento para cessação do tabagismo no SUS de 277 para 80 (71,11%). Conclusões: A diminuição da oferta do tratamento pelo Programa Estadual de Combate ao Tabagismo é preocupante. Ainda que a sua relação com a COVID-19 não esteja completamente elucidada, a cessação do uso do tabaco traz benefícios já bem estabelecidos. Dessa forma, é necessário incentivar a adoção de novas estratégias e tecnologias, aproveitando a janela de oportunidade que o temor da associação COVID-19/tabagismo criou.

Introduction: The new Coronavirus pandemic has had an impact on health systems worldwide. Smokers were directly affected by these changes. Objective: To measure the new Coronavirus pandemic impact on smoking cessation from the analysis of data from the Pernambuco State Tobacco Control Program. Method: Descriptive cross-sectional study, using data from the monitoring strategy of the State Tobacco Control Program of the State Health Secretariat of Pernambuco (SES-PE) as the unit of analysis, comparing services in the second quarter of 2019 and 2020. Results: Between May and August 2019, 3.282 smoking patients sought treatment for smoking cessation in SUS, in Pernambuco. In a similar period, between the months of May and August of the year 2020, treatment for smoking cessation was sought by 680 smoking users, representing a drop of 79,28%. In addition, the number of municipalities offering treatment for smoking cessation in SUS dropped from 97 to 36 (62,89%) and the number of primary health care units providing treatment for smoking cessation in SUS went from 277 to 80 (71,11%). Conclusions: The decrease in the offer of treatment by the State Program to Combat Smoking is worrying. Although its relation with COVID-19 has not been fully elucidated, the cessation of tobacco use has already established benefts. Thus, it is necessary to encourage the adoption of new strategies and technologies, using the window of opportunity that the fear of COVID-19/smoking association created.

Nuevo modelo de distribución de mosquiteros impregnados con insecticida y su impacto durante la Campaña de Cobertura Universal en Mozambique, 2017 / New model for the distribution of mosquito nets impregnated with insecticide and its impact during the Universal Coverage Campaign in Mozambique, 2017

Introducción: En 2017 se realizó la Campaña de Cobertura Universal, en que se aplicó el nuevo modelo de distribución de mosquiteros impregnados con insecticida de larga duración, después de las bajas coberturas encontradas en 2015. Objetivo: Caracterizar el nuevo modelo de distribución de mosquiteros con insecticida de larga duración, aplicado en la Campaña 2017, en la provincia de Tete, Mozambique. Métodos: Se realizóun estudio cuantitativo, descriptivo, observacional y transversal. A partir de estadísticas univariadas, se estimó el porcentaje y sus intervalos de confianza del 95 % para los indicadores de registro correctos. Para encontrar la asociación entre los hogares registrados y los hogares de posesión, se calculó el coeficiente de correlación de Pearson (r) y el coeficiente de determinación (R2). Resultados: De los 3 284 hogares evaluados en la etapa de registro, al 98 por ciento se les asignaron calcomanías, al 99 por ciento cupones, y el criterio de adjudicación de mosquiteros impregnados con insecticida de larga duración fue correcto en el 97 por ciento, respectivamente. De los hogares registrados, 1 086 (97 por ciento) tuvieron acceso a al menos un mosquitero impregnado con insecticida de larga duración y 1 041 (92,9 por ciento) durmieron con estos mosquiteros la noche anterior a la encuesta. Conclusiones: La Campaña de Cobertura Universal, utilizando el nuevo modelo de distribución de mosquiteros impregnados con insecticida de larga duración, asegura un adecuado registro de los hogares, lo que ha contribuido al aumento de su posesión y uso, y al avance hacia el logro de las metas de cobertura universal en la comunidad(AU)

Introduction: As part of the Universal Coverage Campaign implemented in 2017, a new model was applied for the distribution of mosquito nets impregnated with long-lasting insecticide. Coverage had been found to be low in 2015. Objective: Characterize the new model for the distribution of mosquito nets impregnated with long-lasting insecticide applied in the 2017 Campaign in Tete Province, Mozambique. Methods: A cross-sectional observational descriptive quantitative study was conducted. Starting from univariate statistics, estimation was made of percentage and its 95 percent confidence intervals for correct registry indicators. Pearson's correlation coefficient (r) and the coefficient of determination (R2) were estimated to find the association between registered and possessing households. Results: Of the 3 284 households evaluated during the registration stage, 98 percent were given stickers and 99 percent received coupons. The criterion followed for the assignment of mosquito nets impregnated with long-lasting insecticide was correct in 97 percent , respectively. Of the households registered, 1 086 (97 percent) had access to at least one mosquito net impregnated with long-lasting insecticide, whereas 1 041 (92 percent) had slept under these mosquito nets the night before the survey. Conclusions: With the use of the new model for the distribution of mosquito nets impregnated with long-lasting insecticide, the Universal Coverage Campaign ensures the appropriate registration of households, contributing to an increase in their possession and use, and the attainment of universal coverage goals in the community(AU)

Campaña influenza 2020 en contexto de pandemia por SARS-CoV-2: una experiencia inédita de salud pública en Chile / Seasonal influenza campaign 2020 in the context of SARS-CoV-2 pandemic: an unprecedented public health experience in Chile

Resumen Desde 1982, cada año el Departamento de Inmunizaciones del Ministerio de Salud de Chile lleva a cabo la campaña de vacunación contra influenza junto con las Secretarías Regionales Ministeriales-SEREMI, Servicios de Salud y centros de atención primaria de salud. Con los objetivos de prevenir mortalidad y morbilidad grave en grupos de mayor riesgo y de preservar la integridad de los servicios de salud, hasta el 2020 las campañas de vacunación contra influenza serían las más grandes implementadas en Chile, para dar paso, el 2021, a la vacunación contra SARS-CoV-2. Obedeciendo a cambios demográficos y epidemiológicos locales y acogiendo los avances científicos sobre seguridad e inmunogenicidad de la vacuna, el incremento de las vacunas influenza disponibles en Chile forma parte de la planificación anual de la campaña. El 2020, sin embargo, la Campaña Influenza tuvo que ser re-planificada en curso como consecuencia de la incorporación de nuevos grupos a vacunar según dispuso la modificación de la alerta sanitaria por brote de SARS-CoV-2 del 6 de marzo de 2020. Así, de 6.799.800 de dosis, el Departamento de Inmunizaciones logró en menos de dos meses aumentar la disponibilidad a 8.480.325, y cumplir con el compromiso de garantizar el acceso de los grupos de riesgo al beneficio de la vacunación estatal gratuita.

Abstract In Chile, the Immunization Department of the Ministry of Health has carried out the seasonal influenza vaccination campaign annually since 1982 in collaboration with the national health services, regional health offices, and primary health care centres. With the aim of preventing deaths and serious morbidity in high-risk groups and preserving the integrity of health services, the seasonal influenza campaign had been the largest implemented in Chile until 2020, since in 2021 the vaccination campaign against SARS-CoV-2 is expected to become the largest ever implemented. In response to local demographic and epidemiological changes, and taking into account the new scientific evidence on the safety and immunogenicity of vaccines, the influenza vaccines available in Chile would increase annually as a result of campaign planning. In 2020, the influenza campaign had to be re-planned while in progress due to the addition of new high-risk groups to be vaccinated in accordance with the SARS-CoV-2 pandemic health alert modification of March 6th, 2020. Over the course of three weeks, the Immunization Department managed to increase the doses of available influenza vaccines from 6,799,800 previously agreed upon to 8,480,325 and thus serve high-risk groups, guaranteeing their access to state funded influenza vaccination.

Consolidado de recomendaciones del Comité Asesor de Vacunas y Estrategias de Inmunización-CAVEI, sobre priorización de vacunación COVID-19 / Consolidated recommendations of the Advisory Committee on Vaccines and Immunization Strategies- on prioritizing COVID-19 vaccination

Resumen El COVID-19 es un problema de salud pública mundial por su carácter epidémico que, a la fecha, carece de tratamiento farmacológico. Sin embargo, ya se cuenta con algunas vacunas autorizadas para uso en emergencia, aunque la duración de su protección, su capacidad para interrumpir la transmisión viral y su eficacia frente a variantes emergentes de SARS-CoV-2 se encuentran en estudio. La campaña de vacunación contra SARS-CoV-2 de Chile requirió de diseño y planificación, como toda campaña. Parte de estos fue la priorización de grupos objetivo de vacunar, necesaria debido a que el mundo se vería enfrentado a un suministro limitado de vacunas COVID-19. En distintos momentos del año 2020, el CAVEI emitió recomendaciones sobre priorización de grupos de población a vacunar contra SARS-CoV-2, respondiendo a diferentes necesidades y según la evidencia disponible en cada instancia. Éstas se consolidan en la Tabla 1 de este informe. Resumidamente, en fase 1 se recomendó vacunar al personal de salud, residencias de larga estadía y personal crítico del Estado. En fase 2, a personas mayores de 65 años y población con comorbilidades. En fase 3, a personas que cumplen labores esenciales y, finalmente, a la población general.

Abstract COVID-19 is a global public health issue due to its epidemic nature that, to date, lacks pharmacological treatment. However, some COVID-19 vaccines have been authorized for emergency use, although the duration of their protection, their ability to interrupt viral transmission, and their efficacy against emerging variants of SARS-CoV-2 are being studied. Chile's SARS-CoV-2 vaccination campaign required design and planning, like any other campaign. This process included the prioritization of risk groups for vaccination given the limited supply of COVID-19 vaccines globally. Throughout 2020, CAVEI issued recommendations on the prioritization of population groups to be vaccinated against SARS-CoV-2 in response to different needs and in accordance with available evidence. These recommendations are consolidated in Table 1 in this report. In summary, it was recommended that healthcare workers, people in long-term residences and essential State personnel be vaccinated in phase 1. In phase 2, persons over 65 years of age and people with comorbidities. In phase 3, essential tasks workers and, lastly, the general population.

Covid-19 vaccine management (Comirnaty and mrna-1273 Moderna) in a teaching hospital in Italy: a short report on the vaccination campaign

OBJECTIVES@#In this article, we aim to share our experience in the hospital reorganization made to conduct the SARS-CoV-2 vaccination campaign, based on the principles of flexibility and adaptability.@*STUDY DESIGN@#A descriptive study.@*METHODS@#The data concerning the organization of the vaccination campaign were taken from the operative protocol developed by the hospital dedicated task force, composed by experts in hygiene, public health, occupational medicine, pharmacists, nurses, hospital quality, and disaster managers. Data about the numbers of vaccine administered daily were collected by the Innovation and Development Operative Unit database.@*RESULTS@#Vaccinations against COVID-19 started across the EU on the 27th of December 2020. The first phase of the vaccination campaign carried out in our hospital was directed to healthcare workers immunization including medical residents, social care operators, administrative staff and technicians, students of medicine, and health professions trainees. The second phase was enlarged to the coverage of extremely fragile subjects. Thanks to the massive employment of healthcare workers and the establishment of dynamic pathways, it was possible to achieve short turnaround times and a large number of doses administered daily, with peaks of 870 vaccines per day. From the 27th of December up to the 14th of March a total of 26,341 doses of Pfizer have been administered. 13,584 were first doses and 12,757 were second doses. From the 4th to the 14th of March, 296 first doses of Moderna were dispensed. It was necessary to implement adequate spaces and areas adopting anti-contagion safety measures: waiting area for subjects to be vaccinated, working rooms for the dilution of the vaccine and the storage of the material, vaccination rooms, post-vaccination observation areas, room for observation, and treatment of any adverse reactions, with an emergency cart available in each working area.@*CONCLUSIONS@#The teaching hospital of Pisa faced the beginning of the immunization campaign readjusting its spaces, planning an adequate hospital vaccination area and providing an organization plan to ensure the achievement of the targets of the campaign. This represented a challenge due to limited vaccine doses supplied and the multisectoral teams of professionals to coordinate in the shortest time and the safest way possible. The organizational model adopted proved to be adequate and therefore exploited also for the second phase aimed to extremely fragile subjects.

Measuring methods and advertisement planning: Uses of IMC / Métodos de medición y planeación publicitaria: usos de las comunicaciones integradas de marketing (CIM) / Métodos de planejamento e medição de publicidade: usos do IMC

ABSTRACT Given that one of the central elements in marketing spending is advertising, this study aims at analysing how the advertising planning process is influenced by the types of responses expected from the audience, the measurement methods used to assess advertising effectiveness and the expected results. This study was empirical and exploratory based on the application of a cross-sectional survey to 150 marketing managers of medium and large-sized companies in Colombia. The results show if organisations measure the level of compliance with the goals established in terms of IMC, they will make better decisions and allocate marketing budgets consistent with their objectives, resources and capabilities. As the results of the present study indicate, organisations can experience weaknesses in implementing measurement methods that guarantee the proper calculation of organisational results concerning advertising investment.

RESUMEN Dado que uno de los rubros protagonistas en el gasto de mercadeo es la publicidad, este estudio tiene por objetivo analizar cómo los tipos de respuestas esperados por parte de la audiencia, los métodos de medición utilizados para medir la eficacia publicitaria y los resultados esperados, influencian la planeación de la publicidad. Este estudio fue empírico exploratorio a partir de la aplicación de una encuesta de corte transversal a l50 gerentes de mercadeo de empresas medianas y grandes de Colombia. En los resultados se evidencia que los métodos de medición de la eficacia publicitaria no se relacionan de manera significativa con la gestión de la publicidad, lo cual dificulta la obtención de resultados fiables y limita la toma de decisiones organizacional.

RESUMO Dado que um dos principais itens dos gastos de marketing é a publicidade, este estudo tem como objetivo analisar como os tipos de respostas esperadas pelo público, os métodos de medição usados para medir a eficácia da publicidade e os resultados esperados influenciam o planejamento da publicidade. Este estudo foi empírico exploratório a partir da aplicação de uma pesquisa transversal a 150 gerentes de marketing de médias e grandes empresas da Colômbia. Os resultados mostram que os métodos de medir a eficácia da publicidade não estão significativamente relacionados ao gerenciamento da publicidade, o que dificulta a obtenção de resultados confiáveis e limita a tomada de decisão organizacional.

Proceso de co-creación de una cartilla tipo cómic para conocer problemas sentidos por niños(as) campesinos / Process of co-creation of a comic type primer to know problems felt by peasant children

RESUMEN Introducción: El texto deriva del proyecto de extensión solidaria Participación Comunitaria y calidad de vida: un ejercicio de empoderamiento en una población campesina de la Inspección de La Virgen, en Quipile, Colombia. Su objetivo: describir el proceso de co-creación de una cartilla infantil tipo cómic entre niños de ambos sexos de la Inspección de La Virgen (Quipile, Cundinamarca) y el equipo de trabajo de la Universidad Nacional de Colombia Métodos: Se utilizó el diseño participativo para identificar los problemas desde la mirada de los niños. Los participantes pertenecían a la Inspección de La Virgen y a las veredas Galilea, San Nicolás, San Isidro y Estambul. Resultados: Los dibujos hechos por los niños/as inspiraron los títeres de los superhéroes de la obra. Las representaciones en la cartilla simbolizaron los problemas: Contaminación en la quebrada, Discusiones, La contaminación del aire, Las peleas familiares; títulos de las historias de la cartilla Las grandes aventuras de Tony y la Súper Ardilla en La Virgen. Discusión: El uso de la cartilla, en conjunto con los títeres, ayuda a reflexionar con los niños sobre sus realidades. La experiencia puede contextualizarse a comunidades campesinas con características similares. La cartilla constituye una herramienta útil en el proceso de formación de la concientización de problemas sociales en la población infantil.

ABSTRACT Introduction: The text derives from the project of united extension Community participation and quality of life: an empowerment exercise in a rural population of the Inspección de La Virgen, in Quipile, Colombia. Its objective: to value the results of the process of co-creation of an infantile comic type primer prepared by children on their main problems and their possible solutions. Methods: it was used a participative design to identify the problems from the children´s point of view. The participants belonged to the Inspección de La Virgen and to the paths Galilee, San Nicolás, San Isidro and Istanbul. Results: The drawings inspired the marionettes of the superheroes of the work. The representations symbolized the problems Contamination in the gorge, Discussions, The contamination of the air, The familiar fights; titles of the stories of the primer Tony's big adventures and the Super Squirrel in The Virgin. Discussion: The use of the primer, as a whole with the marionettes, helps to reflect with the children on their realities. The experience can contextualize to rural communities with similar characteristics. The primer constitutes a useful tool in the process of formation of the campaign to raise public awareness of social problems in the infantile population.

Knowledge and perceptions regarding immunization among mothers of under five children: a community study from South Kerala

Background: Immunization coverage is undisputedly the most effective health status and outcome indicator.' Though India is effectively organizing vaccination campaigns, a large majority of children are often left out. Strong anti-vaccination propaganda is influencing the decision of parents. This study was initiated in the context of vaccine-preventable disease outbreak rising recently in Kerala to assess the knowledge and practices of mothers of children less than five years regarding immunization.Methods: A cross sectional study was conducted among 140 women with children less than 5 years. Sample was drawn from the rural and urban field practice areas of a tertiary care teaching hospital. A pilot tested interviewer administered questionnaire was used to assess the knowledge and practices of immunization among mothers of under-five children. Chi-Square test was used to find the association between dichotomous variables.Results: In the study group 96.4% of the children were fully immunized. Mean score on knowledge regarding immunization among the study population was 6.45 (SD=1.84). Majority (89%) of the mothers agreed on the importance of vaccination. More than half (57.1%) had heard of anti-vaccination campaign and 24.3% were influenced by it at one time or the other. Higher knowledge score was associated with mothers residing in urban area, better occupation of mother and educational status of father. Age of child, sex, religion, type of family did not influence knowledge level. Factors influencing the perceived importance of vaccination are better occupation of father, higher education status of father and mother.Conclusions: Vaccination was perceived significant for child's health. Immunization coverage in the study population was high. The level of knowledge regarding immunization among the study population was poor. Anti-vaccination campaign has influenced the population at one time or the other.

Communication and awareness on a new vaccine: a cross-sectional study in a tertiary care hospital of West Bengal

Background: Japanese encephalitis (JE) vaccination in India started in 2006 with SA-14-14-2 live attenuated JE vaccine (JEV) following large outbreaks of JE in some districts of Eastern Uttar Pradesh and Bihar in 2005. Age groups 1-15 yrs are first vaccinated with a single dose of JEV in a campaign mode followed by integration of this vaccine in routine immunization. It is beyond doubt that added to vaccination campaigns, proper awareness on JE can play significant role in controlling the disease.Methods: An observational study with cross sectional design was conducted in Kolkata Medical College and Hospital, Kolkata during JE Vaccination campaign during January, 2018 among 85 respondents, to assess the awareness on JE, among care-givers who brought their children for vaccination at the immunization clinic.Results: It was found that only 37.6% the respondents attending the campaign knew the name of the disease; 17.6% respondents were aware about disease transmission, and 5.9% could state two or more clinical features that might be associated with Japanese Encephalitis. 69.4% had no knowledge of up to what age JE vaccines can be administered; 23.5% said it can be administered till the beneficiaries attain fifteen years of age.Conclusions: IEC activities during JE vaccination campaign was not able raise awareness on JE to the desired level. However beneficiaries were informed about service availability and could be mobilised to come for vaccination.

Campanhas educativas de controle do tabagismo: do vício moral ao estilo de vida saudável / Educational smoking control campaigns: from moral addiction to healthy lifestyle / Campañas educativas de control de fumadores: de la adicción moral al estilo de vida saludable

Este artigo é resultado do trabalho de pesquisa sobre a produção das campanhas antitabagistas de governo e sobre a forma com que foram apropriados pela população. Nosso objetivo foi avaliar como essas campanhas foram pensadas em relação aos princípios de comunicação e saúde pressupostos pelo Sistema Único de Saúde. A expectativa foi problematizar a questão numa perspectiva interdisciplinar. Analisamos documentos a partir dos preceitos teóricos e metodológicos da Semiologia dos Discursos Sociais. Concluiu-se que foram criadas campanhas alarmistas, pautadas na imputação do medo e na vigília moral, que acabaram por se distanciar da ideia de uma comunicação em saúde pública dialógica, informativa e participativa.

This article is the result of a research on the use of the concept of aversion in the production of government anti-smoking campaigns and how they were appropriated by the population. Our objective was to evaluate how these campaigns were conceived in relation to the principles of communication and health presupposed by the Unified Health System. The expectation was to problematize the issue from an interdisciplinary perspective. We analyze documents from the theoretical and methodological precepts of Semiology of Social Discourses. It was concluded that alarmist campaigns were created, based on the imputation of fear and on moral vigilance, which eventually distanced these actions from the principles of communication in dialogic, informative and participatory public health.

Este artículo es el resultado del trabajo de investigación sobre la utilización del concepto de aversión en la producción de las campañas antitabaco de gobierno y sobre la forma en que fueron apropiados por la población. Nuestro objetivo fue evaluar cómo estas campañas fueron pensadas en relación a los principios de comunicación y salud presupuestados por el Sistema Único de Salud. La expectativa fue problematizar la cuestión desde una perspectiva interdisciplinaria. Analizamos documentos a partir de los preceptos teóricos y metodológicos de la Semiología de los Discursos Sociales. Se concluyó que se crearon campañas alarmistas, pautadas en la imputación del miedo y en la vigilia moral, que acabaron por distanciarse de la idea de una comunicación en salud pública dialógica, informativa y participativa.

Measles-rubella vaccination campaign: Evaluation of coverage in rural area of Central India

Background: Measles-rubella (MR) vaccination campaign was launched in India in a phasic manner. Maharashtra has launched this in November 2018. Objectives: This study was conducted to evaluate the coverage of MR vaccine in children aged 9–15 years in a rural area of Mohgaon village. Materials and Methods: A community-based cross-sectional study was carried out in the households of the rural village of Mohgaon, with 250 families and 390 eligible children in the age group of 9 months–15 years. Data were collected by the house-to-house visit. Results: Vaccination coverage was found to be 96.41%. Most of the children were in the age group of 6–15 years (74.46%) with no gender bias. Among vaccinated children, 56.25% and 94.27% had thumb mark and vaccination cards, respectively. Less than 5% of the children had minor side effects. Conclusion: Vaccination coverage in a rural area was found to be 96.41%, which is similar to the coverage found other states in an earlier phase.

Perception of parents of private school students on measles and rubella vaccination campaign in Sambalpur town

Background: In order to eliminate measles and rubella (congenital rubella syndrome) WHO has emphasized on measles and rubella (MR) vaccination campaign and India launched the ambitious MR Campaign with the help of WHO and GAVI. In Odisha the MR campaign was launched on January 29 with a target to cover nearly 1.13 crore children. The objective of the present study is to assess the knowledge of parents regarding measles and rubella infection and to identify the source of information regarding MR campaign. Methods: A cross-sectional study was conducted in Sambalpur City across 10 private schools during February 10 to March 12. Total 440 parents of children aged 5-15 years were given a questionnaire about socio-demographic characteristics, knowledge, attitudes, and behaviors towards MR Campaign. The data were collected subsequently in the next 10 days. Out of 440 parents 408 returned filled up questionnaire. Data were entered into and analyzed by using Microsoft Excel.Results: Out of the 408 respondents 362 (88.7%) parents had knowledge about MR campaign. 156 respondents was aware about importance of rubella vaccine. Parent teacher meeting (PTM) was the leading source of information for these. 388 (95%) respondent’s children had received the vaccine during campaign.Conclusions: Parent-teacher's meeting was the main source of information. However social mobilisation such as street play, miking, rallies by school children and NGOs etc., needs to be taken up for such campaigns in future.

Leprosy Case Detection Campaign (LCDC): An Approach to Accelerate Progress to Achieve Leprosy Free India

The Elimination of Leprosy at National level was achieved in the month of December, 2005, by India. Afterward it was observed that trend of two important indicators of NLEP i.e. Annual New Case Detection Rate (ANCDR) and Prevalence Rate (PR) are almost static since 2005–2006, whereas the percentage of Grade II disability (G2D) amongst new cases detected showed a rising trend, which indicated delayed detection of cases and quantum of cases lying undetected/ hidden in the community. Hence, in order to address the issues being faced by programme an innovative approach for hidden case detection i.e., Leprosy Case Detection Campaign (LCDC) was introduced by Central Leprosy Division (CLD), Directorate General of Health Services (Dte.GHS), Ministry of Health & Family Welfare (MoHFW), Govt of India. This novel concept is first of its kind in the world as it has various unique features i.e., institutional framework at various administrative levels for planning, implementation and concurrent review of LCDC, formulation and training of search teams, Micro plan preparation, IEC activities, supervision and monitoring by identified supervisors and report submission. The activity was piloted in the limited areas of 50 districts of 7 states during March-April 2016 and in September, 2016 it was expanded to 163 districts of 20 States/ UTs to cover around 360 million population. During 2017, it was implemented in 255 districts of 23 States/ UTs to cover population of around 390 million. These efforts have yielded the desired result which is evident from the fact that approximately 67000 new leprosy cases were detected during the LCDCs in these 2 years (2016-17 & 2017-18) and number of G2D cases per million population also declined by more than 25%, from 4.48 cases per million in 2014-15 to 3.34 cases per million in 2017-18. In addition to the above, the benefits achieved through LCDCs are generation of large number of trained manpower who can suspect, identify leprosy cases and can carry out focussed IEC regarding leprosy.